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INTRODUCTION: Introduction: the migration process involves change, modification, or acquisition of new eating patterns and ways of eating, which do not always positively impact the health of migrants, being frequently associated with a higher risk of metabolic diseases and excess malnutrition when the quality of food is not adequate. Objective: to analyze the global food quality index (GQI) in the Colombian migrant population in Chile, comparing it with the Chilean population and non-migrant Colombians. Methods: the total sample consisted of 834 individuals over 18 years of age - 206 Colombian migrants residing in Chile, 266 Colombians residing in Colombia, and 362 Chileans. A global food quality index survey was applied to categorize the healthiness of the participants' dietary patterns. Results: there were significant differences in all the ICGA scores analyzed regarding healthy foods, unhealthy foods, and mealtimes. It was observed that Colombians residing in Colombia have the highest score in the healthy classification, while Colombian migrants have the highest figures in the unhealthy condition. Regarding meal times, Chileans are the least compliant with meal times. However, other influences related to food groups stand out. Conclusion: it is necessary to delve deeper into variables linked to the sociodemographic context, analyze potential changes over time, and replicate in migrants of other nationalities to have more information on the relationship between food quality and the migration process.
INTRODUCCIÓN: Introducción: el proceso de migración involucra cambio, modificación o adquisición de nuevos patrones y formas de alimentación, los cuales no siempre impactan de manera positiva en la salud de los migrantes, siendo frecuentemente asociadas a un mayor riesgo de enfermedades metabólicas y malnutrición por exceso cuando la calidad de la alimentación no es la adecuada. Objetivo: analizar el índice de calidad global de la alimentación (ICGA) en la población migrante colombiana en Chile, comparándola con la población chilena y la colombiana no migrante. Material y método: el total de la muestra fue de 834 individuos mayores de 18 años: 206 migrantes colombianos residiendo en Chile, 266 colombianos residentes en Colombia y 362 chilenos. Se les aplicó una encuesta de índice de calidad global de la alimentación para categorizar cuán saludable es el patrón alimentario de los participantes. Resultados: existen diferencias significativas en todos los puntajes analizados del ICGA en cuanto a alimentos saludables, no saludables y por tiempos de comidas. Se observó que los colombianos residentes en Colombia cuentan con el mayor puntaje de clasificación saludable mientras que los colombianos migrantes presentan las más altas cifras dentro de la condición poco saludable. En cuanto a los tiempos de comida, los chilenos son los que menos cumplen con los horarios. No obstante, destacan otras influencias relacionadas con los grupos de alimentos. Conclusión: es necesario ahondar en las variables vinculadas al contexto sociodemográfico, analizar los potenciales cambios en el tiempo y replicar la investigación en migrantes de otras nacionalidades para contar con mayores antecedentes sobre la relación entre la calidad de la alimentación y el proceso migratorio.
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Calidad de los Alimentos , Salud Global/tendencias , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Chile , Colombia/etnología , Encuestas sobre Dietas , Femenino , Salud Global/etnología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: Thyroid ultrasound is a key tool in the evaluation of the thyroid, but billions of people around the world lack access to ultrasound imaging. In this study, we tested an asynchronous telediagnostic ultrasound system operated by individuals without prior ultrasound training which may be used to effectively evaluate the thyroid and improve access to imaging worldwide. METHODS: The telediagnostic system in this study utilizes volume sweep imaging (VSI), an imaging technique in which the operator scans the target region with simple sweeps of the ultrasound probe based on external body landmarks. Sweeps are recorded and saved as video clips for later interpretation by an expert. Two operators without prior ultrasound experience underwent 8 h of training on the thyroid VSI protocol and the operation of the telemedicine platform. After training, the operators scanned patients at a health center in Lima. Telediagnostic examinations were sent to the United States for remote interpretation. Standard of care thyroid ultrasound was performed by an experienced radiologist at the time of VSI examination to serve as a reference standard. RESULTS: Novice operators scanned 121 subjects with the thyroid VSI protocol. Of these exams, 88% were rated of excellent image quality showing complete or near complete thyroid visualization. There was 98.3% agreement on thyroid nodule presence between VSI teleultrasound and standard of care ultrasound (Cohen's kappa 0.91, P < 0.0001). VSI measured the thyroid size, on average, within 5 mm compared to standard of care. Readers of VSI were also able to effectively characterize thyroid nodules, and there was no significant difference in measurement of thyroid nodule size (P = 0.74) between VSI and standard of care. CONCLUSION: Thyroid VSI telediagnostic ultrasound demonstrated both excellent visualization of the thyroid gland and agreement with standard of care thyroid ultrasound for nodules and thyroid size evaluation. This system could be deployed for evaluation of palpable thyroid abnormalities, nodule follow-up, and epidemiological studies to promote global health and improve the availability of diagnostic imaging in underserved communities.
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Accesibilidad a los Servicios de Salud , Telemedicina , Glándula Tiroides/diagnóstico por imagen , Nódulo Tiroideo , Ultrasonografía , Adulto , Femenino , Salud Global/tendencias , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/normas , Accesibilidad a los Servicios de Salud/tendencias , Humanos , Masculino , Área sin Atención Médica , Perú/epidemiología , Mejoramiento de la Calidad , Población Rural , Nivel de Atención , Telemedicina/métodos , Telemedicina/organización & administración , Nódulo Tiroideo/diagnóstico , Nódulo Tiroideo/epidemiología , Ultrasonografía/métodos , Ultrasonografía/normasRESUMEN
Osteosarcoma (OS) is the most common primary bone tumor in children and adolescents. The etiology of OS is largely unknown but may be informed by comparisons of incidence and trends between geographic regions. Using the Cancer Incidence in Five Continents (CI5) data from 1988 to 2012, we present OS age-standardized incidence rates (ASRs; cases/million) and average annual percent change (AAPC) and 95% confidence interval (CI) by geographic region among the age groups 0-9, 10-19, 20-29, 30-59, 60-79, 0-79. Among the 10-19 age group, we also used the most recent data (2008-2012) to present the ASRs for each country. We observed little variation in OS incidence between geographic regions in 2008-2012 across all age groups. Overall, the ASR for 0-79 ranged from 2 cases per million in Southern Asia to 4.2 in Sub-Saharan Africa. A bimodal distribution in incidence was observed with peaks in the 10-19 and 60-79 age groups across all regions over time. Overall, OS incidence was relatively stable across 1988-2012 with the only statistically significant increases in the 0-79 age group observed in Eastern Asia (AAPC: 1.8; 95% CI: 0.6, 1.9) and Sub-Saharan Africa (AAPC: 3.1; 95% CI: 0.5, 5.8). The small variation in incidence between regions and the stability in incidence over time suggests that OS carcinogenesis is not influenced by environmental or time-varying exposures.
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Neoplasias Óseas/epidemiología , Salud Global/tendencias , Osteosarcoma/epidemiología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Lactante , Recién Nacido , Agencias Internacionales , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Tiempo , Adulto JovenRESUMEN
Adolescents comprise one fourth of the world's population, with about 90% of them living in low- and middle-income countries (LMICs). The incidence of depression markedly increases during adolescence, making the disorder a leading cause of disease-related disability in this age group. However, most research on adolescent depression has been performed in high-income countries (HICs). To ascertain the extent to which this disparity operates in neuroimaging research, a systematic review of the literature was performed. A total of 148 studies were identified, with neuroimaging data available for 4,729 adolescents with depression. When stratified by income group, 122 (82%) studies originated from HICs, while 26 (18%) were conducted in LMICs, for a total of 3,705 and 1,024 adolescents with depression respectively. A positive Spearman rank correlation was observed between country per capita income and sample size (rs=0.673, p = 0.023). Our results support the previous reports showing a large disparity between the number of studies and the adolescent population per world region. Future research comparing neuroimaging findings across populations from HICs and LMICs may provide unique insights to enhance our understanding of the neurobiological processes underlying the development of depression.
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Investigación Biomédica/métodos , Encéfalo/diagnóstico por imagen , Depresión/diagnóstico por imagen , Países en Desarrollo , Salud Global , Neuroimagen/métodos , Adolescente , Conducta del Adolescente , Investigación Biomédica/economía , Investigación Biomédica/tendencias , Bases de Datos Factuales/economía , Bases de Datos Factuales/tendencias , Depresión/economía , Depresión/epidemiología , Países en Desarrollo/economía , Salud Global/economía , Salud Global/tendencias , Humanos , Neuroimagen/economía , Neuroimagen/tendencias , Factores de RiesgoRESUMEN
This article highlights the important contributions that the Institute of Nutrition of Central America and Panama longitudinal study has made to global development efforts. The studies have made a unique contribution to our understanding of the role of early life nutrition on many outcomes of interest to the global nutrition community and have strengthened narratives such as human capital.
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Ciencias de la Nutrición del Niño/tendencias , Salud Global/tendencias , Política Nutricional/tendencias , Capital Social , Niño , Ciencias de la Nutrición del Niño/economía , Preescolar , Femenino , Salud Global/economía , Guatemala , Humanos , Lactante , Recién Nacido , Inversiones en Salud , América Latina , Estudios Longitudinales , Masculino , Política Nutricional/economía , Formulación de Políticas , Ensayos Clínicos Controlados Aleatorios como Asunto , Apoyo a la Investigación como AsuntoRESUMEN
Vulvar and vaginal cancers are relatively rare cancers, together responsible for less than 1% of the global cancer incidence among women in 2018. The majority of vaginal cancers and a lesser proportion of vulvar cancers are associated with HPV, with rising incidence rates of vulvar cancer observed in younger women, possibly due to an increased prevalence of high-risk HPV types. This report assesses recent international variations in the incidence rates of vulvar and vaginal cancer derived from high-quality data from population-based cancer registries in 68 countries, and further assesses time trends for selected longer-term series in eight countries (Australia, China, Colombia, India, Norway, Slovakia, the U.S., and the U.K.) over the period 1983 to 2012. We observed a 30-fold variation in the recorded incidence rates of vulvar cancer in contrast with the threefold variation for vaginal cancer. We also observed a rising incidence of vulvar cancer in Australia, Norway and the U.K., and Slovakia, with a more rapid rise in the rates seen in women aged < 60 years at diagnosis. The annual percentage change over the most recent decade varied from 1.7% in Norway to 4.1% in Slovakia. The increases are largely confined to younger women and are likely linked to generational changes in sexual behaviour (earlier age at sexual debut and increasing transmission of HPV among cohorts born 1940 to 1950 and thereafter. Vaginal cancer incidence rates, in contrast, were lower and more stable, despite the higher HPV-attributable fraction relative to vulvar cancer. Irrespective of the trends, an increasing number of women are predicted to be diagnosed worldwide with both cancer types in future decades as population ageing and growth continues. The promise of high-coverage HPV vaccination will likely counter this rising burden, but the impact may take a number of decades.
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Infecciones por Papillomavirus/epidemiología , Neoplasias Vaginales/epidemiología , Neoplasias de la Vulva/epidemiología , Salud de la Mujer/tendencias , Adulto , Factores de Edad , Anciano , Australia/epidemiología , China/epidemiología , Colombia/epidemiología , Femenino , Salud Global/tendencias , Humanos , Incidencia , India/epidemiología , Persona de Mediana Edad , Noruega/epidemiología , Infecciones por Papillomavirus/complicaciones , Sistema de Registros , Eslovaquia/epidemiología , Reino Unido/epidemiología , Estados Unidos/epidemiologíaRESUMEN
Maternal mortality is falling in most of the world's countries, but, for 20 years, the United States has seen no reduction. Over this period, a dozen countries in various stages of development, all spending much less than the United States on health, achieved their United Nations' Millennium Development Goal of 2015 (Millennium Development Goal 5: improve maternal health), with substantial reductions in maternal mortality rates. To consider whether interventions successful in reducing global maternal mortality rates could help the United States to lower its rate, the American College of Obstetricians and Gynecologists, at the 2018 International Federation of Gynecology and Obstetrics' Rio de Janeiro World Congress, convened a panel of the presidents and representatives from five national societies with wide maternal mortality rate ranges and health expenditures and whose national societies had focused on reducing maternal mortality for Millennium Development Goal 5. They identified expanded access to reproductive health care, particularly contraception and safe abortion, as key interventions that had proven effective in decreasing maternal mortality rates worldwide.
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Política de Salud , Mortalidad Materna/tendencias , Salud Reproductiva , Brasil/epidemiología , Etiopía/epidemiología , Femenino , Salud Global/tendencias , Objetivos , Humanos , Nepal/epidemiología , Embarazo , Reino Unido/epidemiología , Estados Unidos/epidemiologíaAsunto(s)
Betacoronavirus , Investigación Biomédica/tendencias , Infecciones por Coronavirus , Salud Global/tendencias , Pandemias , Neumonía Viral , Brasil/epidemiología , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Política de Salud/tendencias , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , SARS-CoV-2Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Cooperación Internacional , Pandemias , Neumonía Viral , COVID-19 , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/prevención & control , Salud Global/tendencias , Humanos , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/economía , Neumonía Viral/prevención & control , SARS-CoV-2 , Factores Socioeconómicos , América del SurRESUMEN
BACKGROUND: The current outbreak of COVID-19 coronavirus infection among humans in Wuhan (China) and its spreading around the globe is heavily impacting on the global health and mental health. Despite all resources employed to counteract the spreading of the virus, additional global strategies are needed to handle the related mental health issues. METHODS: Published articles concerning mental health related to the COVID-19 outbreak and other previous global infections have been considered and reviewed. COMMENTS: This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally. Collective concerns influence daily behaviors, economy, prevention strategies and decision-making from policy makers, health organizations and medical centers, which can weaken strategies of COVID-19 control and lead to more morbidity and mental health needs at global level.
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Betacoronavirus/patogenicidad , Infecciones por Coronavirus , Salud Global/tendencias , Salud Mental/tendencias , Pandemias , Neumonía Viral , COVID-19 , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/psicología , SARS-CoV-2Asunto(s)
Creación de Capacidad/métodos , Salud Global/tendencias , Evaluación de Programas y Proyectos de Salud/métodos , Responsabilidad Social , Cicatrización de Heridas , Argentina , Creación de Capacidad/tendencias , Salud Global/normas , Humanos , Estomía/métodos , Estomía/enfermería , Evaluación de Programas y Proyectos de Salud/tendencias , Estomas Quirúrgicos/tendenciasRESUMEN
This paper describes efforts by public health practitioners to address a health crisis caused by economic development policies that are unrestrained by either environmental, public health, or human rights mandates. Economic development projects funded by international funding institutions like the Inter-American Development Bank that reduce poverty when measured in terms of Gross Domestic Product (GDP) per capita in the transborder region between Suriname and French Guiana harm minority populations where commercial activities destroy, alter, and remove the resources upon which local communities depend. In this study, the structural causes of a community health crisis affecting Indigenous people in the transborder region between Suriname and French Guiana was addressed by seeking gatekeepers in government who have access to policy-making processes. We found that deeply rooted economic development policies structured social, economic, and political alliances and made them resistant to feedback and reform. We concluded that work must be focused beyond the simple exchange of public health information. Public health practitioners must become politically active to create new policy commitments and new patterns of governance that advance development as well as improve health outcomes. Failure to do so may result in public health practitioners becoming 'engaged followers' that are complicit in the inhumanity that springs from their acquiescence to the authority of government officials when their policies are the cause of preventable death, disease, and disability.
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Diplomacia , Economía , Salud Global , Gobierno , Política , Salud Pública , Países en Desarrollo/economía , Países en Desarrollo/estadística & datos numéricos , Salud Global/estadística & datos numéricos , Salud Global/tendencias , Humanos , Salud Pública/estadística & datos numéricos , Política Pública , SurinameRESUMEN
Objetivo: identificar as redes de colaboração internacional para vigilância das anomalias congênitas, elencar os programas que as compõem e comparar suas principais características. Métodos: revisão narrativa de literatura, mediante busca na base MEDLINE (via PubMed), em endereços on-line, relatórios e documentos oficiais. Resultados: foram identificadas seis redes de colaboração internacional para a vigilância de anomalias congênitas (ECLAMC, ICBDSR, EUROCAT, BINOCAR, SEAR-NBBD e ReLAMC), compostas por 98 programas presentes em 58 diferentes países de todos os continentes, exceto a África; as principais características quanto ao tipo de vigilância, cobertura e localização foram discutidas de modo comparativo. Conclusão: as redes colaborativas internacionais constituem importantes atores para a vigilância das anomalias congênitas, contribuindo com o entendimento do cenário epidemiológico global desses agravos, além de atuar tanto para o fortalecimento de programas individuais já existentes quanto para a criação de iniciativas de vigilância em regiões desassistidas.
Objetivo analizar la prevalencia de enfermedades respiratorias y diarrea en trabajadores de cooperativas de materiales reciclables en São Paulo, Brasil, y factores asociados. Métodos: estudio transversal en tres cooperativas, con datos recopilados por entrevistas estructuradas y medición de la concentración fungica ambiental; se usó la regresión de Poisson para estimar las razones de prevalencia (RP). Resultados: 156 personas fueron entrevistadas; la mayor prevalencia de asma, enfermedad pulmonar obstructiva crónica (EPOC) y diarrea se produjo en cooperativas con la mayor concentración fúngica total; se observó una mayor prevalencia ajustada de asma en la cooperativa A (RP=8,44 - IC95% 1,09;65,37) y diarrea en C (RP=2,09 - IC95% 1,11;3,94), en comparación con la cooperativa B; la mayor prevalencia de EPOC se observó en los fumadores y ex fumadores (RP=8,66 - IC95% 2,84;26,35). Conclusión: se deben adoptar medidas de control fúngica como prevención de enfermedades en cooperativas de materiales reciclables.
Objective: to identify international congenital anomaly surveillance collaboration networks, to list the programs that compose them and to compare their main characteristics. Methods: this was a narrative literature review by means of a MEDLINE database search (via PubMed) and searches involving websites, reports and official documents. Results: six international congenital anomaly surveillance collaboration networks were identified (ECLAMC, ICBDSR, EUROCAT, BINOCAR, SEAR-NBBD and ReLAMC), comprised of 98 programs present in 58 different countries on all continents, except Africa; the main characteristics regarding type of surveillance, coverage and location were discussed in a comparative manner. Conclusion: international collaborative networks are important players for congenital anomaly surveillance, contributing to the understanding of the global epidemiological scenario of these conditions, in addition to acting both to strengthen individual existing programs and also to create surveillance initiatives in unassisted regions.
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Humanos , Anomalías Congénitas/epidemiología , Monitoreo Epidemiológico , Cooperación Internacional , Salud Global/tendencias , Redes de Información de Ciencia y TecnologíaRESUMEN
RESUMEN La hipertensión arterial es una causa modificable muy prevalente de enfermedades cardiovasculares, accidentes cerebrovasculares y muerte. Medir con exactitud la presión arterial es fundamental, dado que un error de medición de 5 mmHg puede ser motivo para clasificar incorrectamente como hipertensas a 84 millones de personas en todo el mundo. En la presente declaración de posición se resumen los procedimientos para optimizar el desempeño del observador al medir la presión arterial en el consultorio, con atención especial a los entornos de ingresos bajos o medianos, donde esta medición se ve complicada por limitaciones de recursos y tiempo, sobrecarga de trabajo y falta de suministro eléctrico. Es posible reducir al mínimo muchos errores de medición con una preparación adecuada de los pacientes y el uso de técnicas estandarizadas. Para simplificar la medición y prevenir errores del observador, deben usarse tensiómetros semiautomáticos o automáticos de manguito validados, en lugar del método por auscultación. Pueden ayudar también la distribución de tareas, la creación de un área específica de medición y el uso de aparatos semiautomáticos o de carga solar. Es fundamental garantizar la capacitación inicial y periódica de los integrantes del equipo de salud. Debe considerarse la implementación de programas de certificación de bajo costo y fácilmente accesibles con el objetivo de mejorar la medición de la presión arterial.(AU)
ABSTRACT High blood pressure (BP) is a highly prevalent modifiable cause of cardiovascular disease, stroke, and death. Accurate BP measurement is critical, given that a 5-mmHg measurement error may lead to incorrect hypertension status classification in 84 million individuals worldwide. This position statement summarizes procedures for optimizing observer performance in clinic BP measurement, with special attention given to low-tomiddle- income settings, where resource limitations, heavy workloads, time constraints, and lack of electrical power make measurement more challenging. Many measurement errors can be minimized by appropriate patient preparation and standardized techniques. Validated semi-automated/automated upper arm cuff devices should be used instead of auscultation to simplify measurement and prevent observer error. Task sharing, creating a dedicated measurement workstation, and using semi-automated or solar-charged devices may help. Ensuring observer training, and periodic re-training, is critical. Low-cost, easily accessible certification programs should be considered to facilitate best BP measurement practice.(AU)
RESUMO A hipertensão é uma causa altamente prevalente de doença cardiovascular, acidente vascular cerebral e morte. A medição precisa da pressão arterial (PA) é um aspecto crítico, uma vez que erros de mensuração da ordem de 5 mmHg podem levar a uma classificação incorreta do status de hipertensão em 84 milhões de pessoas em todo o mundo. O presente posicionamento resume os procedimentos para otimizar o desempenho do observador (o indivíduo responsável pela mensuração da PA) na mensuração clínica da PA, com atenção especial para contextos de baixa a média renda, onde recursos limitados, cargas de trabalho pesadas, restrições de tempo e falta de energia elétrica tornam mais desafiadora a tarefa de medir a PA. Muitos erros de mensuração podem ser minimizados pela preparação adequada do paciente e pelo uso de técnicas padronizadas. Para simplificar a mensuração e evitar erros do observador, devem-se utilizar dispositivos semiautomatizados ou automatizados validados, com manguito para braço, ao invés de auscultação. O compartilhamento de tarefas, a criação de uma estação de trabalho dedicada à mensuração e o uso de dispositivos semiautomatizados ou com carga solar podem ajudar. É essencial que seja assegurado o treinamento e retreinamento periódico do observador. Programas de certificação de baixo custo e de fácil acesso devem ser considerados para facilitar a adoção das melhores práticas na mensuração da PA.(AU)
Asunto(s)
Humanos , Oscilometría , Monitores de Presión Sanguínea/provisión & distribución , Salud Global/tendencias , Equipos de Medición de Riesgos , Hipertensión/prevención & controlRESUMEN
Objetivos. El boletín de notas de México correspondiente al 2018 evalúa las oportunidades a disposición de la población infantil y joven mexicana para que puedan desarrollar niveles adecuados de actividad física y sueño, y disminuyan el sedentarismo.Métodos. El boletín es un sistema de vigilancia que recopila los datos obtenidos en las encuestas nacionales, censos, documentos gubernamentales, sitios web, literatura gris y estudios publicados con respecto al análisis de 16 indicadores en 4 categorías: comportamientos diarios, estado físico, entornos y fuentes influyentes, y estrategias e inversión. Los datos fueron cotejados con los puntos de referencia establecidos. A cada indicador se le asignó una calificación entre 1 y 10 (< 6 significa reprobado) o fue marcado como "incompleto" si los datos eran nulos o insuficientes. Resultados. Las calificaciones obtenidas para los comportamientos diarios fueron: actividad física en general: 4; participación en actividades deportivas organizadas: 5; juego activo: 3; modalidades de transporte activas: 5; sueño: 7; y sedentarismo: 3. El estado físico obtuvo un 7. Las calificaciones para los entornos y fuentes influyentes fueron: familiares y pares: "incompleto"; escuela: 3; comunidad y entorno: 4. Para las estrategias e inversión: estrategias gubernamentales: 6; entidades no gubernamentales: 2.Conclusiones. Las bajas calificaciones obtenidas en 11 de los 16 indicadores demuestran que las escuelas, las familias, las comunidades y el gobierno tienen que aunar esfuerzos para mejorar las oportunidades que tiene la población infantil y joven en México para desarrollar niveles de actividad física satisfactorios.(AU)
ABSTRACT The Lancet Commission on Hypertension identified that a key action to address the worldwide burden of high blood pressure (BP) was to improve the quality of BP measurements by using BP devices that have been validated for accuracy. Currently, there are over 3 000 commercially available BP devices, but many do not have published data on accuracy testing according to established scientific standards. This problem is enabled through weak or absent regulations that allow clearance of devices for commercial use without formal validation. In addition, new BP technologies have emerged (e.g. cuffless sensors) for which there is no scientific consensus regarding BP measurement accuracy standards. Altogether, these issues contribute to the widespread availability of clinic and home BP devices with limited or uncertain accuracy, leading to inappropriate hypertension diagnosis, management and drug treatment on a global scale. The most significant problems relating to the accuracy of BP devices can be resolved by the regulatory requirement for mandatory independent validation of BP devices according to the universally-accepted International Organization for Standardization Standard. This is a primary recommendation for which there is an urgent international need. Other key recommendations are development of validation standards specifically for new BP technologies and online lists of accurate devices that are accessible to consumers and health professionals. Recommendations are aligned with WHO policies on medical devices and universal healthcare. Adherence to recommendations would increase the global availability of accurate BP devices and result in better diagnosis and treatment of hypertension, thus decreasing the worldwide burden from high BP.(AU)
RESUMO A Comissão Lancet sobre Hipertensão Arterial identificou que uma iniciativa central para enfrentar a carga mundial da hipertensão arterial seria a melhoria na qualidade da mensuração da pressão arterial pelo uso aparelhos de pressão arterial validados quanto à acurácia. Atualmente, existem mais de 3 000 aparelhos de pressão arterial disponíveis comercialmente; entretanto, muitos não têm dados publicados sobre testes de acurácia realizados de acordo com padrões científicos estabelecidos. Este problema resulta de regulamentação fraca ou inexistente, o que permite a aprovação para uso comercial de dispositivos sem validação formal. Além disso, surgiram novas tecnologias de mensuração da pressão arterial (por exemplo, sensores sem algemas) sem consenso científico quanto aos padrões de acurácia. No conjunto, essas questões contribuem para a oferta generalizada de dispositivos de pressão arterial clínica e domiciliar com acurácia limitada ou incerta, levando a diagnóstico, gerenciamento e tratamento inadequados da hipertensão em escala global. Os problemas mais significativos relacionados com a acurácia dos dispositivos de pressão arterial podem ser resolvidos por regulamentação que imponha a obrigatoriedade de validação independente dos aparelhos de pressão arterial, de acordo com a norma universalmente aceita pela Organização Internacional de Normalização. Esta é uma recomendação fundamental para a qual existe uma necessidade internacional urgente. Outras recomendações essenciais incluem o desenvolvimento de padrões de validação especificamente para novas tecnologias de mensuração da pressão arterial e listas on-line de aparelhos com acurácia adequada que sejam acessíveis aos consumidores e profissionais de saúde. As recomendações estão alinhadas com as políticas da Organização Mundial da Saúde (OMS) sobre dispositivos médicos e atenção universal à saúde. A adesão às recomendações aumentaria a oferta global de dispositivos de pressão arterial com acurácia adequada e resultaria em melhor diagnóstico e tratamento da hipertensão arterial, diminuindo assim a carga mundial dessa doença.(AU)
Asunto(s)
Salud Global/tendencias , Equipo para Diagnóstico/normas , Tecnología Biomédica , Presión Arterial , Estándares de ReferenciaRESUMEN
We will analyze and comment on the book Health Diplomacy and Global Health: Latin American Perspectives, edited by Paulo Marchiori Buss and Sebastián Tobar and published by Editora Fiocruz. Throughout its 653 pages, the book brings prominent national and foreign authors in the field of Health Diplomacy and Global Health, depicting a decade in which Brazil had great international protagonism in the field of Public Health, especially in South-South cooperation, in an innovative and structuring manner. Furthermore, the chapters present theoretical aspects and basic principles of Global Health as a new field of knowledge, in which the country has been developing and sharing scientific production with a Latin American perspective, focused on the pursuit of equity and health for all peoples of the world.
Asunto(s)
Reseñas de Libros como Asunto , Diplomacia/tendencias , Salud Global/tendencias , Brasil , Humanos , América LatinaRESUMEN
BACKGROUND: With global survival increasing for children younger than 5 years of age, attention is required to reduce the approximately 1 million deaths of children aged 5-14 years occurring every year. Causes of death at these ages remain poorly documented. We aimed to explore trends in mortality by causes of death in India, China, Brazil, and Mexico, which are home to about 40% of the world's children aged 5-14 years and experience more than 200â000 deaths annually at these ages. METHODS: We examined data on 244â401 deaths in children aged 5-14 years from four nationally representative data sources that obtained direct distributions of causes of death: the Indian Million Death Study, the Chinese Disease Surveillance Points, mortality data from the Mexican Instituto Nacional de Estadística y Geografía, and mortality data from the Brazilian Institute of Geography and Statistics. We present data on 12 main disease groups in all countries, with breakdown by communicable and nutritional diseases, non-communicable diseases, injuries, and ill-defined causes. To calculate age-specific and sex-specific death rates for each cause, we applied the national cause of death distribution to the UN mortality envelopes for 2005-16 for each country. FINDINGS: Unlike Brazil, China, and Mexico, communicable diseases still account for nearly half of deaths in India in children aged 5-14 years (73â920 [46·1%] of 160â330 estimated deaths in 2016). In 2016, India had the highest death rates in nearly every category, including from communicable diseases. Fast declines among girls in communicable disease mortality narrowed the gap by 2016 with boys in India (32·6 deaths per 100â000 girls vs 26·2 per 100â000 boys) and China (1·7 vs 1·5). In China, injuries accounted for the greatest proportions of deaths (20â970 [53·2%] of 39â430 estimated deaths, in which drowning was a leading cause). The homicide death rate at ages 10-14 years was higher for boys than for girls in Brazil, increasing annually by an average of 0·7% (0·3-1·1). In India and China, the suicide death rates were higher for girls than for boys at ages 10-14 years. By contrast, in Mexico it was higher for boys than for girls, increasing annually by an average of 2·8% (2·0-3·6). Deaths from transport injuries, drowning, and cancer are common in all four countries, with transport accidents among the top three causes of death for both sexes in all countries, except for Indian girls, and cancer in the top three causes for both sexes in Mexico, Brazil, and China. INTERPRETATION: Most of the deaths that occurred between 2005 and 2016 in children aged 5-14 years in India, China, Brazil, and Mexico arose from preventable or treatable conditions. This age group is important for extending some of the global disease-specific targets developed for children younger than 5 years of age. Interventions to control non-communicable diseases and injuries and to strengthen cause of death reporting systems are also required. FUNDING: WHO and the University of Toronto Connaught Global Challenge.